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In his 2014 State of the State address, Vermont Governor Peter Shumlin devoted significant attention to the growing epidemic of opioid addiction in his state where the number of deaths from heroin overdoses doubled between 2012 and 2013 with a 770% increase in treatment for opiate addiction from 2000-2013. This situation continues to play out across the country with numerous news stories highlighting the contemporary heroin problem. Continue reading →

Last September, the Miss America competition’s talent portion featured Kelley Johnson, Miss Colorado, a registered nurse, who appeared on stage wearing nurses’ scrubs with a stethoscope around her neck. Johnson’s talent was delivery of a monologue about her experience caring for Joe, a patient with Alzheimer ’s disease. In a competition where the majority of contestants choose to enact a song or dance, Johnson’s performance stood out as unique. But it was comments made about Johnson’s monologue the following day by the co-hosts of ABC’s The Viewwhich hurled Johnson, and the nursing profession, into the public spotlight. Continue reading →

Last month, the nation marked the 10 year anniversary of Hurricane Katrina reminding us of the powerful and destructive impact disasters exert on people’s lives. In a similar vein, a recently released book Nurses and Disasters: Global Historical Case Studies(Editors Arlene W. Keeling and Barbra Mann Wall), examines the role of nurses in responding to historic and recent global disaster such as Hurricane Katrina. Given the Katrina anniversary and the relevance of understanding responses to disasters, I interviewed the editors of Nurses and Disasters some questions about the book and why it should be read.

What inspired you to put together a book on nurses and disasters?

The inspiration for Nurses and Disasters: Global Historical Case Studies came from three sources. First and foremost was the success of our first book, Nurses on the Front Line: When Disaster Strikes, 1878-2010, on nurses’ roles in disasters in the United States. There was worldwide interest in that book and after its translation into Chinese, we were all too cognizant of the fact that we had only written about disasters in the US — and clearly, disasters are occurring on an almost daily basis around the world. The second impetus for this book was the Ebola crisis and the attention that American nurses received when they succumbed to the virus as opposed to nurses in Africa. The inattention to the nurses who suffered and died from the disease in Africa was striking, and we wanted to draw attention to the race, gender, and class disparities that persist today in the health care arena. Thus, we highlight the Ebola crisis in the preface and conclusion of the book. The third factor that drove our decision to write Nurses and Disasters was the fact that there has long been a silence associated with nurses’ roles in the major disasters occurring during World War II. While some attention has been paid to them for their roles as nurse anesthetists on the European front, and their heroic efforts in Bataan, little attention has been given to the actions of the British nurses during the Blitz, the nurses who attended trauma patients in Pearl Harbor, or the Japanese nurses’ courageous efforts when they too were victims of the atomic bombing. Giving voice to these nurses was very important to us.

Did you uncover any surprises about the role of nurses during disasters that you either didn’t know about or believed had been understudied or misunderstood by previous histories on disasters?

Some findings were not surprising, such as disparities that occurred in responses to the indigenous people in Alaska, who did not receive needed help during the flu epidemic. What hasn’t really been discussed much when one thinks about disasters is how nurses themselves were under attack as well, making it very difficult to implement meaningful responses to the evolving chaos. Certainly after 9-11, firefighters became the heroes because they persevered in their roles despite the risks, and many died as a result. Similarly, nurses were under attack in many of the case studies highlighted in the book. The Japanese nurses after the Hiroshima bombing who also were injured, the nurses caring for those with SARS and who contracted the disease themselves, nurses in the Bar Harbor fire – all of those nurses continued to work as the disaster unfolded. For various reasons, they saw it as their duty to continue working holding to their obligation to care. Yet the chapters point to the consequences of such duty to care. They call attention to nurses’ ethical and moral dilemmas and conflicts among their personal, family, and professional obligations. They felt compelled to “nurse.” Yes, their actions were heroic, but the price nurses paid to care were great, as some died, others became ill themselves, while others suffered lasting survivors’ guilt. These issues need further study.

What would you say are the main policy implications coming from the findings of Nurses and Disasters?

The policy implications that emerge from our research and documentation of nurses’ roles in disasters are quite simple. Nurses – who serve on the front lines of disasters—should be a part of local, state and federal disaster preparedness councils along with physicians and other health care providers, first responders, fire and rescue. Care should be coordinated; lines of communication clear; and supplies available. Nurses should be educated as to their role and how to keep themselves safe, and should be provided the proper equipment and support to do so.

Who should read this book and why?

The audience for Nurses and Disasters is huge. Of course nurses, physicians, policy makers, historians of nursing and medicine and women represent the usual audience for a book on this topic but also nursing students and students studying the health care system are finding both our books on nursing in disasters to be very interesting and pertinent. Thus we encourage faculty members to require the book for courses in public health, leadership, nursing issues, and other courses.

“A small number of very premature babies are surviving earlier outside the womb than doctors once thought possible, a new study has documented, raising questions about how aggressively they should be treated…”

Though this statement was made regarding present studies, it could have easily been published 40 years ago during the early years of neonatal intensive care in the United States. Indeed, our current fascination with saving sick babies is not a recent phenomenon, but one whose roots sink back over the past century.

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The following blog entry is the first in a series exploring archival issues of relevance from both historical and contemporary perspectives. For more information about the Barbara Bates Center for the Study of the History of Nursing’s archives and collections, please visit our website at http://www.nursing.upenn.edu/history

“Male nurses are found to earn about $5,000 more than female colleagues.” (Not quite) shocking news! A recently released JAMAstudy, hitting numerous airwaves and media outlets found significant pay discrepancies between nurses who are female and nurses who are male. How could this happen in the most female (women make up about 93% of all nurses) profession? The study did not address reasons why pay inequity exists in nursing, yet, reports on the results offered some hypotheses. One of the study’s investigators suggested that men may negotiate better (Ouch, that rationale literally hurts!) or that women experience a tougher time getting promoted. Investigators plan to carry out additional research focusing on explanations for pay gaps in nursing.

Anna Ingram, PGH ’02 and Five Physicians, c.1903. Alumni Association of the Philadelphia General Hospital School of Nursing Image Collection, Barbara Bates Center for the Study of the History of Nursing, University of Pennsylvania

Interested in the history of nursing and medicine in Philadelphia? Check out these links to local institutions with archives, collections and events related to our city’s rich history.